The OHSU Knight Cancer Institute provides expert care for multiple myeloma and other plasma cell disorders. Our doctors focus on specific blood disorders, giving them rare expertise on the best treatments for your condition. Our care and treatment options include:

• A range of specialists working together to develop the most effective treatment recommendations for you.
• A weekly meeting where doctors from multiple specialties combine their expertise to tailor care to your needs.
• Expertise in rare plasma cell disorders, such as POEMS syndrome, light chain deposition disease, and AL amyloidosis.
• A nurse coordinator who can arrange your appointments and answer your questions.
• Oregon’s largest bone marrow/stem cell transplant program.
• A type of immunotherapy called CAR T-cell therapy for multiple myeloma.
• Access to promising new treatments through clinical trials led by some of the world’s leading blood cancer researchers.
• Support services to help you and your family manage cancer treatment and side effects.

What is multiple myeloma?

Multiple myeloma is a cancer of the plasma cells, a type of blood cell found in bone marrow. These cells normally make antibodies that kill germs. When the plasma cells  grow out of control, they can crowd out normal cells in the bone marrow, form tumors and release abnormal proteins. Eventually, these changes can damage organs or bones, and lead to infections.

Patients with myeloma are classified as having either:

• Asymptomatic (smoldering) myeloma: These patients don't have symptoms and, outside of clinical trials to test therapies, don't receive treatment. 
• Active (symptomatic) myeloma: These patients have symptoms and receive treatment.

Who gets multiple myeloma?

About 36,000 new cases of multiple myeloma are diagnosed in the U.S. every year, according to the National Cancer Institute. Roughly 179,000 people in the U.S. are living with the disease.

The cause is unknown, but risk factors include:

• Age: More than 85% of patients are 55 or older at diagnosis.
• Race: Black people are at higher risk.
• Family history: Having a parent, child or sibling with the disease is linked to higher risk for reasons scientists don’t fully understand.

Survival rates for multiple myeloma

A key concept in understanding survival is five-year relative survival rate. This is the percentage of people who are still alive five years after they were first diagnosed, compared to the general population. (It doesn’t count death from other causes.)

Survival rates for multiple myeloma are better if the condition is caught early. Unfortunately, the condition is often not caught until it has spread.

The overall five-year relative survival rate for multiple myeloma is 61%, according to the National Cancer Institute. The rate is 87% for people whose myeloma is caught before it spreads.

It's important to remember that statistics are averages and can’t predict the outcome for any one patient. It's also important to remember that these figures are based on the treatments that were available more than five years ago. Patients who are diagnosed now may have a better outlook. Treatments are getting better all the time. Over the last 30 years, for example, the survival rate for multiple myeloma has doubled.

Symptoms of multiple myeloma

You may not have symptoms early on. When you do have symptoms, they can include:

• Bone pain
• Nausea and appetite loss
• Weight loss
• Confusion
• Frequent, severe infections
• Numbness or weakness in legs

Diagnosing multiple myeloma

A routine blood test, physical exam and medical history are often the first steps in making a diagnosis. Additional tests may include:

Blood and urine tests: Doctors use these tests to measure blood protein levels and to see how aggressive the cancer is.

Imaging tests: Scans can look for bone damage caused by multiple myeloma.

Bone marrow biopsy: We collect tissue and fluid from your bone marrow with a thin needle. Doctors examine the samples to look for plasma cells and abnormal proteins. 

Multiple myeloma stages

Doctors assign a stage to your myeloma to indicate how advanced it is and what kind of treatments will work best. We use a staging system that looks at:

• Levels of two proteins, albumin and beta-2-microglobulin
• The amount of a substance called lactate dehydrogenase, or LDH, in your blood
• Genetic abnormalities

Stage I: Beta-2-microglobulin is less than 3.5 milligrams per liter. The albumin level is at least 3.5 grams per deciliter. LDH levels are normal. No “high-risk” genetic abnormalities are found.

Stage II: Not Stage I or III.

Stage III: Beta-2-microglobulin is at least 5.5 milligrams per liter. LDH levels are high. “High-risk” genetic abnormalities are present.

Multiple myeloma treatments

Other therapies for multiple myeloma

These therapies may help manage symptoms and side effects of treatment.

Bone therapies: Myeloma cells can dissolve or weaken bones. Bisphosphonates are IV medications that can counteract the damage and prevent further bone loss. Denosumab, a type of immunotherapy given in a shot, targets cells that weaken bone.

Kyphoplasty and vertebroplasty: Myeloma can cause bone fractures in your spine. Minimally invasive kyphoplasty and vertebroplasty inject plastic cement into the spinal column to stabilize your spine and reduce pain.

Complementary medicine: We offer acupuncture and other complementary therapies to ease the side effects of treatment for multiple myeloma.

Multiple myeloma clinical trials and research

Clinical trials: We offer access to leading-edge clinical trials for patients with all stages of multiple myeloma. Our doctors work with researchers nationwide to develop new treatments for myeloma patients, including those who no longer benefit from standard therapies.

Cancer registries: Cancer registries are databases of patient information that can include blood and tissue samples. They help scientists understand how cancer works so they can develop better treatments and work toward cures. Learn about our registries, including one for bone marrow transplant patients, and see how you can contribute to research.

Learn more

• Multiple Myeloma, American Cancer Society
• What is Multiple Myeloma?, Multiple Myeloma Research Foundation
• Plasma Cell Neoplasms (Including Multiple Myeloma), National Cancer Institute
• Multiple Myeloma, Cancer.Net, American Society of Clinical Oncology